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Table of Contents
VIDEO ARTICLE
Year : 2022  |  Volume : 11  |  Issue : 3  |  Page : 174-175

A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy


Department of Gynecology, the Huaian Maternity and Child Clinical College of Xuzhou Medical University, Huaian, Jiangsu, China

Date of Submission10-Feb-2022
Date of Decision07-Apr-2022
Date of Acceptance04-May-2022
Date of Web Publication5-Aug-2022

Correspondence Address:
Dr. Chunhua Zhang
Department of Gynecology, Huai'an Maternity and Children Hospital, No. 104, Renmin South Road, Qingjiangpu District, Huaian, Jiangsu 223300
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gmit.gmit_19_22

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How to cite this article:
Li Q, Fang F, Zhang C. A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy. Gynecol Minim Invasive Ther 2022;11:174-5

How to cite this URL:
Li Q, Fang F, Zhang C. A Self-Made Bag-Assisted Laparoendoscopic Single-Site Surgery in Ovarian Teratomectomy during Pregnancy. Gynecol Minim Invasive Ther [serial online] 2022 [cited 2022 Aug 15];11:174-5. Available from: https://www.e-gmit.com/text.asp?2022/11/3/174/353424




  Objective Top


The objective is to demonstrate stepwise self-made bag technique and surgical technique in managing ovarian dermoid cystectomy in pregnant patients through laparoendoscopic single-site surgery (LESS). The reported incidence of ovarian cysts in pregnancy varies from 0.05% to 1.2%; compared with open surgery, laparoscopic surgery adnexal cyst during pregnancy does not increase the risk to mother and fetus.[1],[2] In addition, LESS has better postoperative recovery. However, conventional laparoscopic surgery is safer than LESS.[3]


  Design Top


Stepwise demonstration of the technique with narrated video footage.


  Interventions Top


The patient was a 31-year-old woman, gravida 3, para 2, at a gestational age of 15 weeks, who was diagnosed with 5.6 cm × 4.1 cm right ovarian teratoma and 2.0 cm × 2.3 cm left ovarian cyst. Ovarian teratomectomy was performed at the same time of the previous cesarean section in 2018. A self-made bag-assisted LESS approach to ovarian teratoma with several key strategies to minimize fetal impact, ovarian damage, and blood loss [Video 1]:

  1. Make a retrieval bag [Figure 1] before surgery with an inner packaging bag of the disposable suction tube
  2. Place the affected ovary in the retrieval bag and pull the bottom of the retrieval bag to the umbilicus to reduce the stimulation of the uterus by surgical procedures [Figure 2]
  3. Cut the surface of the affected ovary with a cold blade to reduce ovarian damage [Figure 3]
  4. Dissect the teratoma pedicle with an ultrasonic knife to reduce bleeding.
Figure 1: Make a retrieval bag before surgery by suturing around one side of the inner packaging bag of suction tube http://www.apagemit.com/page/video/show.aspx?num=292&kind=2&page=1

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Figure 2: Pull the bottom of the retrieval bag to the umbilicus to reduce the stimulation of the uterus

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Figure 3: Suture the ovary for hemostasis and shaping

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.


  Conclusion Top


When performing an ovarian cystectomy under LESS, we could use an upside down specimen bag to conveniently remove the cyst from the abdominal cavity with no spillage of toxic dermoid contents. A self-made specimen bag is cost-saving and convenient to use. The operation has the least impact on the pregnant uterus and avoids the impact on the fetus. Availability of a cold knife and hand suturing can maximize ovarian tissue preservation, leading to better protection of ovarian function.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ball E, Waters N, Cooper N, Talati C, Mallick R, Rabas S, et al. Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG). Facts Views Vis Obgyn 2019;11:5-25.  Back to cited text no. 1
    
2.
Cho HW, Cho GJ, Noh E, Hong JH, Kim M, Lee JK. Pregnancy outcomes following laparoscopic and open surgery in pelvis during pregnancy: A nationwide population-based study in Korea. J Korean Med Sci 2021;36:e192.  Back to cited text no. 2
    
3.
Lin Y, Liu M, Ye H, He J, Chen J. Laparoendoscopic single-site surgery compared with conventional laparoscopic surgery for benign ovarian masses: A systematic review and meta-analysis. BMJ Open 2020;10:e032331.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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